科研之友
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摘要
Background. - Urinary tract infection (UTI) is one of the most frequent community-acquired infection. Escherichia coli resistance has been on the rise since 2000s.
Methods. - We conducted a prospective multicenter cohort study including adults who had a positive urine cytobacteriological examination (UCBE) performed in our Parisian suburb laboratory platform from October 2014 to March 2015.
Results. - A total of 1223 patients were included: 995 (81.4%) women and 228 (18.6%) men. Gram-negative bacilli were isolated in 91% of cases: E. coli accounted for 69.4% of cases. Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) prevalence was 4.2%. Resistance of ESBL-producing E. coli strains to amoxicillin, fluoroquinolones, nitrofurantoin, and fosfomycin was respectively 100%, 80%, <5%, and < 10%. Risk factors for bacteriuria caused by ESBL-PE were older age (OR = 3.7 [1.99-14.4]; P= 0.02), recurrent UTI (OR = 3.7 [1.9-7.2]; P= 0.05), immunosuppression (OR = 9.2 [4.1-19.47]; P = 0.01), recent hospitalization within the last three months (OR = 4.5 [2.3-8.3]; P = 0.05), and recent antibiotic therapy (OR = 13.4 [6.29-31.9]; P < 0.01).
Conclusion. - The prevalence of ESBL-PE bacteriuria seems to be 4%. Older age, immunosuppression, recurrent UTI, recent hospitalization, and antibiotic therapy are the main risk factors associated with ESBL-PE community-acquired UTI.
- 出版日期2018-5
